Journey Mapping for Symptom Management in Adolescents with Depression: A Longitudinal Qualitative Study of Dynamic Patient-Centered Pathways

作者：Shihan Fang, Fazhan Chen, Xiaoying Zhu, Jing Bian, Jinshen Zhang, Yating Wang, Yanbo Wang · 发表于：Journal of Multidisciplinary Healthcare · 年份：2025 · DOI：10.2147/jmdh.s533788 · 被引用次数：1 · 研究领域：Treatment of Major Depression、Digital Mental Health Interventions、Mental Health Research Topics

Purpose: This longitudinal qualitative study aimed to explore the dynamic symptom management journeys of adolescents with depression, integrate Symptom Management Theory (SMT) with journey mapping, and identify stage-specific characteristics, emotional experiences, and unmet needs across the illness trajectory to inform targeted interventions. Methods: A longitudinal qualitative design with reflexive thematic analysis (RTA) was adopted. Twelve adolescents with depression (aged 12-18 years) were recruited from a tertiary psychiatric hospital in Zhejiang Province, China. Data were collected through semi-structured interviews at three time points: baseline, 1-month, and 3-month follow-ups, supplemented by observation notes and self-management diaries. Journey mapping was used to visualize dynamic interactions across four phases (symptom recognition, help-seeking, treatment engagement, and daily management), with longitudinal integration of data to track temporal changes. Results: The symptom management journey was non-linear, characterized by distinct emotional and behavioral patterns across phases: numbness and self-loathing during symptom recognition (eg, self-harm as emotional outlet, somatization like headaches); fear and shame in help-seeking (eg, passive medical-seeking due to family coercion, reliance on online support); oscillating hope and skepticism during treatment (eg, selective adherence to preferred therapies like hypnotherapy over Modified Electroconvulsive Therap...